New-Graduate Nurse Simulation Interventions with STEMI Patients to Build Competencies
Question
I have attached the papers to place all together as a research paper.
You will be using the same paper from the NR 621 course and adding on the Evaluation Results and Conclusion section of the paper, you do want to change your PICOT question since that would require you to rewrite most of your paper.
Use your headings! You should have the following headings (these are in bold)
Results
Quantitative Data: This is the numbers part of your results. Just identify the nuts and bolts of the numbers. This can be presented in a table format.
Qualitative Data: This would be the themes that emerged out of your project if you did a qualitative survey. This could also be the explanation of comments that may have been given from students if you had open-ended questions. **Not all projects will have a qualitative section.**
Evaluation of the Intervention: Based on the data you just reported in your results, was your intervention effective? Yes or no? Why or why not?
Limitations of the Project: What limitations did you run into? Think about what types of limitations that you reported in your research summary table as you were evaluating other research. Did you have those same limitations?
Summary of Findings: What are your final takeaways from the findings? What are your next steps?
Implication for Theory Development: How does this relate to your theory? What additional support does this give to your chosen theory?
Implications for Further Research: What other research should be considered? Should you duplicate on a bigger sample, different types of populations?
Implications for Teaching/Clinical Practice: What do the results of this project mean for further practice? Should there be a change of practice based on your results?
Conclusion (this is the conclusion of the ENTIRE project). You should discuss everything (PICOT question, theory, intervention, a quick summary of the research, results, and next steps). This will be a few paragraphs total.


Solution
New-Graduate Nurse Simulation Interventions with
STEMI Patients to Build Competencies
Simulated clinical methods can help students shift from
students to practitioners in ST-Elevation Myocardial Infarction (STEMI). Hence
it is essential to look into how simulation can help this transition. Simulation
training should include debriefings and a group known as INACSL (International
Association of Clinical Simulation and Learning). Because it helps students
comprehend what, how, and why they are learning, debriefing is a crucial part
of the learning process. Observational knowledge is a critical component of STEMI in
high-fidelity simulations. It is frequently cited as a desirable and necessary
step in learning consolidation and transfer. Learning Simulation Interventions with STEMI
Patients helps students strengthen their interpersonal skills and
ethical frameworks and work through challenging scenarios.
Besides making sure their students understand examples and
approaches, healthcare educators want them to think critically about them, make
conclusions, and provide creative solutions to clinical problems. Simulated
training and debriefing must be incorporated into the educational process to
employ STEMI
as an educational supplement. Debriefings, rather than lectures, are
often regarded as a reflective learning strategy that allows students to explore
how a new topic is applied to their prior knowledge. Incorporating technology
into the classroom is beneficial and has better patient outcomes. Nursing
students who participate in STEMI exercises improve their skills, including
recognizing geriatric patients, effectively triaging emergencies, caring for
patients, and working cooperatively in an obstetrics context. Simulator-based
approaches to healthcare teaching are not yet conclusive but will influence how
nurses use simulation models with STEMI Patients. New graduate nurses'
communication and evaluation abilities during their first six months of nursing
practice may be affected by their participation in simulation-based training
exercises, or not.
Synthesis of the Literature
Before the advent of online learning, graduate nurses were
trained in classrooms, research laboratories, or at the patient's bedside,
where they could immediately put their new abilities into practice. A growing
body of research points to the need for creative methods of teaching future
nurses how to perform high-fidelity evaluations, think critically and
communicate with colleagues from various disciplines (Mamun & Alouani,
2020). Patients and learners benefit from using a patient simulator instead of
traditional training techniques. Students can hone their clinical skills while
studying in a safe environment (Xu & Yang, 2020). More research is needed
on the competency level of newly graduated nurses who have done simulation
training because of the abundance of evidence-based and anecdotal accounts. As acuity
levels among hospital patients rise, nurses become increasingly underprepared
to work successfully in complex clinical conditions.
The reality of the learning
environment and equipment
Participation in roleplaying in simulation-based tests has
improved STEMI Patients' critical thinking, self-efficacy, and communication
skills. Efficacy is a person's faith in their abilities, regardless of the
circumstances. Self-efficacy can be increased by practicing and mastering a craft
(Huber & Quinn, 2018). Using high-fidelity simulation situations, critical
thinking skills may be taught to STEMI nurses, helping them develop positive
habits such as self-assurance, a context-sensitive point of view,
inventiveness, adaptability, and a sense of wonder (Bakracheski et al., 2020).
It is then time to figure out how the most effective learning methods and
experiences might be incorporated into nursing practice.
Staffing and equipment costs are
worth STEMI students' self-confidence
To see if novice nurses are better prepared to care for STEMI
patients, Hooda & Sweeny (2021) switch from traditional classroom
instruction to simulation-based training. STEMI simulation-based training has
been called into question by academics who fear it may decrease the transfer of
skills from the classroom to clinical practice. Research on how simulation labs
might be used to improve education is needed in light of these and other
factors. In rural or remote places where emergency treatment is provided, Landi et al.
(2022) feel STEMI simulation-based instruction is necessary. A mobile
education unit was used to simulate classroom instruction for the objectives of
this research. These facilities can be used for up to seven days for training
in obstetrics, surgery, and combat trauma.
Staffing and equipment costs are
worth students' learning outcomes
Multiple STEMI patient simulation was used in a recent
randomized trial to examine novice nurses' ability to make decisions and follow
up on patients, recognize changes in their status and interpret assessment
data, take the initiative, work independently, and complete tasks within
specified time frames, anticipate risk and delegate tasks, and keep track of
all these things. Movahed et al. (2022) employed PowerPoint voice-overs,
professional modeling, and reading assignments to gather data. The American
Nurses Association and the National League for Nursing support this technology
in nursing simulation training. In terms of data collection, the two raters at
both study sites were almost perfectly on the same page, according to the kappa
statistic (Tabl,
2020). Comparing changes from baseline in competent behavioral
performance between the three groups revealed no statistically significant
differences. The number of simulations increased significantly before and after
group dissolution (Braeschke et al., 2019). Overall performance improved
dramatically over time no matter what training was used. Students who participate
in simulation models with STEMI Patients gain first-hand knowledge of how
priorities are set and distributed (Khaire, 2020). Typically, each nurse in a
hospital unit is accountable for at least two patients. This can be
advantageous if responsibilities are appropriately assigned.
Summary of the Literature
The high-stakes simulation models with STEMI Patients suggest
that rater training may be uneven, biased, and lacking in impartiality. This
holds accurate even when dealing with more difficult abilities or situations. A
landmark Movahed
et al. (2022) study stressed the need to utilize valid and reliable
foundations to assess practice success and competency. The findings of this
study are consistent with those of that study. Researchers working in rater
training must evaluate the competency of the raters and agree on the necessity
for a shared mental model of expected performance behaviors in a simulation
scenario to be successful.
Concerning the PICOT, a consistent set of assessment
instruments used by experienced clinical observers is essential to uncover best
practices to improve STEMI students' academic, educational, and professional
outcomes. This is the largest and most comprehensive study for undergraduate
nursing students interested in substituting simulation-based learning for traditional
clinical training.
Intervention and Evaluation Plan
Objectives
A short-term goal is to deliver and implement a system
that explains the PICOT issue and predicts the expected conclusion. Students'
conceptual schemata for a particular idea are enhanced when they are reminded
of what they learned in a single week of instruction. STEMI has been intended
to be exceptionally flexible to accommodate a wide range of participants with
varying degrees of expertise and experience. As a long-term goal, the initiative
aims to aid nursing educators in reinforcing the unique learning requirements
of nursing students who fall short of expectations in their courses. The
program's attrition rate is expected to be reduced. The high-fidelity
simulation could help nurses better comprehend their current and future
practice options. Simulations in the classroom can help students improve their
communication skills and prepare them for the clinical scenario. When a
simulation is used to instruct students in an evidence-based skill or
technique, the students can practice and receive feedback on their performance.
Critical thinking skills can be fostered through simulation-based education.
Description of the Practicum Site and Stakeholders
Students attended weekly sessions designed to help them
fill in gaps in their understanding. The University Campus served as the
location for the practicum. Program implementation is intended to benefit
students in the accelerated bachelor's program. Students from the School of Nursing
are the primary stakeholders in this case. More robust knowledge of nursing
ideas will be available to all students if professors have easy access to the
interventions being taught on campus. Students benefit from using simulation
laboratories to familiarize themselves with and grasp the intricacies of the
hospital environment. Because of this, students can benefit from ongoing
education in a learning environment that pushes their abilities while also
allowing them to understand and improve therapeutic outcomes when approaches
are standardized. It is feasible to assess and increase staff competence by
using simulations. Talented students are more likely to adhere to established
industry norms because they are more confident in their abilities. Simulator
labs can help investigators find flaws in the current systems or practices that
led to a fatal event, allowing for their correction.
Change Model
When in the nursing field, one needs to be up to date on
the latest trends and developments. Thus, educational institutions face the
difficulty of successfully regulating these changes in student enrollment. An
institution's ability to respond quickly to shifting conditions is essential to
stay abreast of current best practices. The ADKAR model is the best choice in
this situation. In this method, the five steps are Awareness (desire),
Knowledge (abilities), and Reinforcement (Awareness). Organizations that want
to improve their ability to recognize and respond to change and get the best possible
results must follow the model's five stages. There has been increasing use of the
ADKAR model in clinical and academic contexts. An in-depth examination of its
effects will necessitate additional investigation. Observing what students take
away from the ADKAR model can help individuals learn from them. The use of
simulation laboratories by nursing students is on the rise as an alternative to
hands-on clinical training. Students in future nursing programs will have
difficulty deciding on the most effective learning method. As soon as possible,
a new policy must be implemented that includes clinical hours at the hospital
and clinical practice hours in the ADKAR model. Shortly, there will be a need
for more research into the future of simulation lab training and the creation of
a standardized system of scenarios based on evidence and assessed for quality
results. The rising use of simulation labs for continuing education and
competency in the clinical setting necessitates policy changes.
Implementation
Plan
This
project needs to be adjusted since first-semester nursing students cannot
integrate concepts they have previously studied into their clinical experiences.
A new teaching method being considered for implementation shortly involves
holding weekly workshops in the classroom to reinforce critical concepts.
Attending these sessions may benefit students who have fallen behind in understanding
new nursing facts and ideas. Adopting the ADKAR Model of Change is essential to
an organization's long-term change efforts, allowing it to succeed. If
first-year nursing students in the baccalaureate nursing program fail to grasp
the fundamentals of nursing, patient care and health outcomes may suffer in the
future. Many students are unprepared to recognize and respond to their
patients' health deterioration, even though cardiac arrest is the most common
outcome. High-fidelity patient simulation has been proven to improve physical
products when used for training in adult patient care. However, there is a lack
of research on children in distress. Due to their role as first responders,
students have an opportunity to affect their learning outcomes. Identifying and
cultivating high-performance skills can be helpful in this area.
Evaluation
When planning interventions for nursing students at the
end of their first semester, the project manager drew on the ADKAR Model of
Change to help guide them. Evidence-based practice (EBP) and good memory of
nursing concepts and theories are not linked in clinical simulations and
assessments of students. It is expected that Miramar's nursing students will
apply the ADKAR Model of Change in this project to help them enhance their
academic and professional performance while completing their degrees. Students can
practice responding to and coping with various circumstances in a realistic
working environment without endangering the patient's safety. Deteriorating
pediatric patients' clinical outcomes are heavily impacted by their students'
belief in their abilities and the severity of their disease, which is
compounded by their Awareness of their medical situation.
Evaluation Results
Students could compare their summative assessment A
performance to their first content reviewed test performance to see how well they
retained the newly provided nursing ideas over the previous two weeks. They
could also see how the weekly workshops that served as STEMI project
reinforcement for the content they learned impacted their progress in the
class. When the class's overall performance was compared to the results of
their first summative assessment and their first content-based assessment, the
initial evaluation was conducted.
The clinical skills and knowledge of nursing students were
strengthened by participation in practical workshops that utilized a variety of
instructional modalities. The first topic review exam results from this group
of nursing students indicated that the weekly reinforcement sessions were a
success. Despite his initial reluctance, this project manager's mentor was keen
for her to record the class's overall performance before and after the
reinforcement sessions when she asked about recording individual student
performance in the type where she was working on her STEMI project.
The way students are educated in nursing schools is
evolving along with the field itself. There are a lot of challenges that
educational institutions must deal with, both academically and
administratively. A constant reminder that progress is being made or that an
organization's current style of conducting itself requires improvement is
provided by the occurrence of the change. An essential part of the ADKAR
transformation model focuses on a person's ability to change their state of
mind based on their current state of knowledge and desire. Together, they help
a firm realize its full potential so that the best outcomes can be part of the
solution to find and resolve the recognized problem that calls for change. The
project manager's case study shows that first-year nursing students cannot use
the verbal and practical abilities previously taught in their STEMI Project.
This scenario necessitates a shift in perspective. A weekly classroom workshop
style is recommended as a teaching technique to ensure that students have the
background information necessary to grasp new nursing concepts. Using the ADKAR
Model of Change, companies may make changes more smoothly and consistently,
boosting their chances of success by defying employee resistance for longer.
Nursing students' academic performance and progress will be addressed in the STEMI
Project, which aims to improve patient care and improve health outcomes in the
long term.
After each weekly course, this project manager
administered a two-question survey to participants to determine their level of
satisfaction. The project manager gave students a pre-assessment before the
simulation briefing. An after-simulation evaluation instrument was provided and
collected immediately following the conclusion of the simulation briefing
session. An evaluation tool was replaced with three questions that students
answered during the pre-briefing part of the simulation, which was given to
them after the simulation was done. Four nurse roles were needed for the
simulated clinical environment established by this project manager and mentor.
First-year nursing students must understand the critical
link between evidence-based practice and accurate recall of nursing concepts
during evaluations and clinical simulations. Adopting the ADKAR Model of Change
for this STEMI Project was essential to ensuring its success. This project
manager considered the ADKAR Model of Change as a guide for implementing the
planned interventions and evaluating their outcomes. Summative assessment A
will be used to compare classroom performance with the initial test performance
of content-reviewed students following exposure to the weekly workshops for
this STEMI project.
Numerical and qualitative techniques measure the
effectiveness of the STEMI project's weekly reinforcement of newly learned
skills. Independent variables included a week-long workshop for first-semester
nursing students focused on reinforcing recently discovered clinical reasoning
skills in evidence-based practice in nursing. A comparison was made between
students who chose to attend the weekly workshops to support information and
those who did not to determine whether or not the workshops affected their
academic and clinical outcomes. When the class's overall performance was
compared to the results of their first summative assessment and their first
content-based assessment, the initial evaluation was conducted. Students could
compare their summative assessment performance to their first content reviewed
test performance to see how well they retained the newly provided nursing ideas
over the previous two weeks. They could also see how the weekly workshops that
served as STEMI project reinforcement for the content they learned impacted
their progress in the class.
Conclusion
There has been some discussion about
using virtual simulations to help doctors better respond to patients who are
not doing well. Reinforcement as a teaching method was examined in this project
to see if it could help first-year nursing students better understand and
retain new concepts. First-year nursing students in an accelerated nursing
program took part in the study. Adult and pediatric patient simulations were
used in a 16-hour training session for the treatment group. According to the
implications of this project results for theory development, nurses who
participate in STEMI can better identify patients in decline, have greater
confidence in themselves, and are more knowledgeable of critical care
procedures than nurses who do not participate in STEMI.
Throughout the studies, intervention
and results confirmed the theory used in the intervention by evaluating the
best way to treat an adult patient who was rapidly decompensating while waiting
for a team of rapid response responders to get on the spot. Working in an
interdisciplinary team and maintaining clear lines of communication in
high-stress situations were both stressed during the training as part of the
collaboration concept Simulations were prepared and implemented according to
the International Nursing Association's Clinical Simulation and Learning
Standards of Best Practice for Simulation Facilitation. The RRT was activated
in all of the cases of STEMI.
This project's research question was,
"Were patients treated with STEMI to resolve more difficult medical
concerns?" A new body of knowledge about the advantages of using STEMI has
been added, building on previous research and aiding team communication in
dynamic contexts. Other teachers should implement this intervention because
simulating a STEMI patient, finding RRT criteria, and developing communication
skills with both patients and healthcare team members are the most valuable
components of the experience.
References
Bakracheski, N., Mojsovska, V., &
Kovaceska-Bashuroska, E. (2020). CRT-100.34 importance of organized STEMI
network for the improvement of contact-to-Wire time and 30-Day mortality rate
in STEMI patients. JACC: Cardiovascular Interventions, 13(4),
S8-S9. https://doi.org/10.1016/j.jcin.2020.01.023
Braeschke, L., Braun, I., Kapp, F.,
& Hara, T. (2019). Integrate confidence ratings in audience response
systems in order to help students to self-regulate their learning
process. Proceedings of the 11th International Conference on Computer
Supported Education. https://doi.org/10.5220/0007731404090415
Hooda, A., & Sweeny, J. (2021). Acute
coronary syndrome: STEMI and Non-STEMI interventions. Practical Manual
of Interventional Cardiology, 259-266. https://doi.org/10.1007/978-3-030-68538-6_20
Huber, K., & Quinn, T. (2018). Systems
of care for patients with acute ST elevation myocardial infarction (STEMI
networks). Oxford Medicine Online. https://doi.org/10.1093/med/9780199687039.003.0042_update_002
Khaire, D. U. (2020). Incidence of
Cardiogenic shock in acute Stemi patients Thrombolysed with Streptokinse. Journal
of Medical Science And clinical Research, 08(02). https://doi.org/10.18535/jmscr/v8i2.51
Landi, A., Gargiulo, G., &
Valgimigli, M. (2022). The effects of Cangrelor on platelet aggregation in
STEMI patients. JACC: Cardiovascular Interventions, 15(2),
229-230. https://doi.org/10.1016/j.jcin.2021.11.016
Mamun, M. M., & Alouani, A.
(2020). Diagnosis of STEMI and Non-STEMI heart attack using nature-inspired
swarm intelligence and deep learning techniques. Journal of Biomedical
Engineering and Biosciences. https://doi.org/10.11159/jbeb.2020.001
Movahed, M. R., Hashemzadeh, M., &
Movahed, M. R. (2022). CRT-100.06 the occurrence of ST elevation
myocardial infarction (STEMI) and Non-STEMI in patients with post-traumatic
stress disorder (PTSD) using the large nationwide inpatient sample (NIS). JACC:
Cardiovascular Interventions, 15(4), S1-S2. https://doi.org/10.1016/j.jcin.2022.01.074
Tabl, M. A. (2020). CRT-100.31 safety of
Ticagrelor post-fibrinolysis in STEMI patients. JACC: Cardiovascular
Interventions, 13(4), S7. https://doi.org/10.1016/j.jcin.2020.01.020
Xu, J., & Yang, Y. (2020). Integrated
gene expression profiling analysis reveals potential molecular mechanisms and
candidate biomarkers for early risk stratification and prediction of STEMI and
Post-STEMI heart failure patients. https://doi.org/10.21203/rs.3.rs-118025/v1
Appendix A – Literature
Sourcing Methods
1. The
Library and Resources page offered a variety of databases that could be used
to find pertinent information, including renowned academic sources. |
2. Many
nursing publications and other resources are covered as nursing research.
National Institutes of Health (NIH)-owned MEDLINE is a search engine for
PubMed. |
3. Two
examples of online resources include Ovid, a healthcare database, and
Medline, a biomedical database. |
4. Full-text
research with an abstract that has been published in the recent five years |
5. English-language
and peer-reviewed journals are available through the library's subscriptions.
It was fascinating to hear how the authors started in the literary world. |
6. The
"and " operators weed out any documents that lack keywords. |
Appendix B - The ADKAR
model
![]() |
Appendix C – Teaching
Plan
1. Curriculum |
2. Initiatives |
3. Adjustments |
4. Learning
Outcomes |
5. Resource
Acquisitions |
6. Important
Charges |




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